MEDICARE: TARGET GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	1001863380	NV

General Provider Information

NPI Number	:	1407090442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARGET GROUP, INC.

Provider Business Mailing Address
First Line	:	2881 BUSINESS PARK CT
Second Line	:	SUITE 226
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9018
Country	:	US
Telephone Number	:	702-385-1000
Fax Number	:	702-452-1001

Provider Business Practice Location Address
First Line	:	2881 BUSINESS PARK CT
Second Line	:	SUITE 226
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9018
Country	:	US
Telephone Number	:	702-385-1000
Fax Number	:	702-452-1001

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GINO D CATALLI
Credential	:
Telephone Number	:	702-385-1000

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/21/2009

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